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Reflectance confocal microscopy (RCM) is a noninvasive imaging technique that has been used to diagnose basal cell carcinoma (BCC). How accurate is RCM to predict whether a BCC is infiltrative or superficial?

The 2006 study {2} was inconclusive:

Limitations: The pigmented BCCs imaged in this study were predominantly nodular; a different set or additional criteria may be necessary for detection of infiltrative and metatypical BCCs.

The 2016 study {1} focused on superficial basal cell carcinoma (sBCC) but only looked at 3 cases.

Motivations:

  1. Understanding if RCM is a decent replacement for a biopsy to diagnose BCC.
  2. Superficial BCCs can be treated quite well with Imiquimod 5% cream (US brand: Aldara) but Imiquimod not doesn't work as well on infiltrative BCCs, which typically requires surgery (Mohs if cosmesis is important or old-fashioned excision).

References:

  • {1} Ghita, Mihaela A., Constantin Caruntu, Adrian E. Rosca, Harillaq Kaleshi, Ana Caruntu, Liliana Moraru, Anca Oana Docea et al. "Reflectance confocal microscopy and dermoscopy for in vivo, non-invasive skin imaging of superficial basal cell carcinoma." Oncology letters 11, no. 5 (2016): 3019-3024. https://dx.doi.org/10.3892%2Fol.2016.4354 ; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4840988/
  • {2} Agero, Anna Liza Chan, Klaus J. Busam, Cristiane Benvenuto-Andrade, Alon Scope, Melissa Gill, Ashfaq A. Marghoob, Salvador González, and Allan C. Halpern. "Reflectance confocal microscopy of pigmented basal cell carcinoma." Journal of the American Academy of Dermatology 54, no. 4 (2006): 638-643. https://doi.org/10.1016/j.jaad.2005.11.1096

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